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Re: Double depression, failing

Posted by Elizabeth on May 25, 1999, at 15:55:23

In reply to Double depression, failing, posted by John on May 24, 1999, at 18:33:15

Hi John. I'm far from one to advocate weird "alternative" things, but it seems to me that SAMe has a lot of potential.

Desipramine is a tricyclic that is very specific for norepinephrine (no sex problems), and it also has fewer side effects than the other TCAs.

Lithium is pretty cool. Low-dose (like 0.5-0.8mEq/L) lithium can be used with an AD to maximize desired effects and minimize adverse effects. It's a good AD by itself as well and is supposed to be very good for dysthymia. If you're looking towards mood stabilizers you also might consider Lamictal.

Pindolol isn't much good on its own; you start out an SSRI, MAOI, Effexor, certain tricyclics - basically any drug that increases serotonin levels - with pindolol (about 7.5mg/day, in 3 doses) and it makes the AD start working faster.

I haven't heard much good about moclobemide. I think it would be better to start one of the regular MAOIs - there're several threads that mention them.

I do think Effexor is a good idea, perhaps with pindolol; Effexor will not necessarily cause the same sexual problems as the SSRIs, or if it does they might not be as bad. It's worth trying. Use the slow-release stuff (XR).

But anyway there's lots of stuff out there. Don't give up!




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